Two successful models for preparing competent critical care nurses. The Parkland Health and Hospital System Critical Care and Trauma Nurse Internship and Critical Care Residency.

Part of the mission statement of Parkland Health and Hospital System involves participating in educational programs dedicated to the art and science of caring for the sick and injured, the promotion of wellness, and the delivery of health services. The concept of the Nurse Internship and Nurse Residency fits well in the framework of this hospital. The continued support of these programs from the PHHS administration is visible evidence of the institution's commitment to excellence. Together these programs provide a continual supply of competent critical care practitioners to meet the never-ending demand in this large county facility as well as opportunities for new graduates to begin the exciting and rewarding journey into critical care nursing.

Physiologic rationale of Sv-O2 monitoring.

Mixed venous oxygen saturation is a global indicator of the balance between oxygen transport and oxygen demand. In critically ill patients, the delivery of adequate quantities of oxygen to meet the cellular oxygen demands is paramount. While parameters such as SaO2, PaO2, and CO reveal important information about oxygen transport, the SvO2 indicates the adequacy of supply in relation to tissue oxygen demands.

Fat embolism syndrome: a variant of ARDS (continuing education credit).

Fat embolism syndrome (FES) is a relatively uncommon, life-threatening sequela of long-bone fractures. Occurring 24 to 48 hours postinjury, the syndrome manifests as hypoxemia, confusion, and petechiae. The pathophysiologic changes in the lung are consistent with those of ARDS. Nursing priorities include an awareness of risk factors, familiarity with signs and symptoms, and a high index of suspicion in patients with multiple long-bone fractures.